Drug interactions
Cannabidiol + Ketoconazole
Severity: Moderate
Cannabidiol and Ketoconazole: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Ketoconazole can raise cannabidiol exposure because cannabidiol is cleared partly by CYP2C19 and CYP3A4. Higher levels may increase somnolence, sedation, diarrhea and liver enzyme elevations.
What this interaction means in plain words
Cannabidiol and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cannabidiol belongs to Central Nervous System; Ketoconazole belongs to Anti Fungals.
Why it happens
Ketoconazole inhibits CYP3A4 and to some extent CYP2C19, reducing cannabidiol metabolism.
What to do
Monitor for sedation, adverse effects and liver enzymes, and consider reducing the cannabidiol dose if adverse effects appear.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Ketoconazole
- Alfuzosin + Ketoconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Avanafil + Ketoconazole Contraindicated
- Conivaptan + Ketoconazole Contraindicated
- Dihydroergotamine intranasal + Ketoconazole Contraindicated
- Dihydroergotamine + Ketoconazole Contraindicated
Other interactions of Cannabidiol
- Cannabidiol + Phenytoin Major
- Cannabidiol + Sodium valproate Major
- Cannabidiol + Tacrolimus Major
- Abiraterone + Cannabidiol Moderate
- Alogliptin-pioglitazone + Cannabidiol Moderate
- Amiodarone + Cannabidiol Moderate
Frequently asked questions
Can I take Cannabidiol with Ketoconazole?
MediHelp rates the interaction as moderate. Cannabidiol and Ketoconazole can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ketoconazole can raise cannabidiol exposure because cannabidiol is cleared partly by CYP2C19 and CYP3A4. Higher levels may increase somnolence, sedation, diarrhea and liver enzyme elevations.
How serious is the interaction between Cannabidiol and Ketoconazole?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for sedation, adverse effects and liver enzymes, and consider reducing the cannabidiol dose if adverse effects appear.
What other medicines interact with Ketoconazole?
MediHelp also lists interactions of Ketoconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Ketoconazole page.
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